Everything You Need to Know About Cervical Cancer

Every year, nearly 13,000 women in the U.S. are diagnosed with cervical cancer. Thanks to advanced vaccination and screening options, cervical cancer is one of few cancers that’s highly preventable and treatable.

January marks Cervical Health Awareness Month. In collaboration with the American Cancer Society, healthcare organizations across the country are actively fighting cervical cancer on all fronts. We’re helping more women get tested, understand their diagnosis, and get the treatments they need. And we’re supporting new research to help prevent, find, and treat cervical cancer.

At Frederick Health, we believe it all starts with education. This month, join us in learning more about cervical health and what you can do to prevent cervical cancer.

Understanding Cervical Cancer

Cervical cancer starts in the cells lining the cervix, or the lower part of the uterus. Typically, the normal or healthy cells of the cervix will gradually develop pre-cancerous changes that evolve into cancer. These changes can be detected during your Pap screening, which is recommended every 3 years for women ages 21 and older. If abnormal cells are found, they can be treated to prevent cancer from developing.

Only some women with pre-cancerous cells will actually develop cancer. For most women, pre-cancerous cells will go away without any treatment. For others, these cells turn into true (or invasive) cancers. In 2018, the American Cancer Society estimates about 13,240 new cases of invasive cervical cancer will be diagnosed—about 4,170 women will die from cervical cancer.

What is HPV?

HPV is short for Human Papilloma Virus. Most HPV types cause warts on the skin, on the arms, chest, hands, or feet. Other types can be found in the body’s mucous membranes, such as the vagina, anus, mouth, and throat. It’s important to note that genital HPV is not the same as HIV or herpes.

HPV can be passed from person to person by skin-to-skin contact and sexual activity. It’s a very common infection—most men and women who have ever had sex get at least one type of genital HPV in their lifetimes. You can have HPV even if it has been years since you were sexually active, and even if you do not have any signs or symptoms.

HPV is especially devastating to women because nearly all cervical cancers are caused by HPV. That’s why screenings are so important—cervical cancer can be found early and even prevented with routine screening tests. The Pap screening looks for changes in cervical cells caused by HPV infection, while the HPV test looks for the infection itself.

Unfortunately, there’s no way to prevent HPV infection. However, there are some things you can do to lower your chances of being infected. Consider the HPV vaccine, using condoms during sexual activity, and limiting your number of sexual partners. And, most importantly, get tested.

Cervical Cancer Screening Guidelines

Early screening offers the best chance of finding and treating cervical cancer and HPV that can lead to cervical cancer. The sooner you’re screened, the earlier abnormal cervical cell changes can be detected and treated before they turn into cervical cancer.

When found early, cervical cancer is one of the most successfully treated cancers. In the U.S. alone, the cervical cancer death rate declined by more than 50% over the last 30 years, primarily thanks to Pap test screenings.

According to the American Cancer Society, these guidelines should be followed to help detect early cervical cancer:

• All women should begin screenings at age 21. Women aged 21-29 should have a Pap test every 3 years.
• Women 65 years and older who have had regular screenings in the previous 10 years should stop cervical cancer screening as long as they haven’t had any serious pre-cancers found in the last 20 years.
• Women aged 30 to 65 should be tested with a Pap test combined with an HPV test every 5 years—or every 3 years with just the Pap test.
• Women at higher risk of cervical cancer because of a suppressed immune system (due to HIV or organ transplants, for example) or those who were exposed to DES (diethylstilbestrol) in utero may need to be screened more often. Please follow your healthcare provider’s recommendations.
  • Women in this age group with a history of CIN2 or CIN3 should continue screenings for at least 20 years after the abnormality was found.
• Women of any age should NOT be screened every year by any screening method.
• Women who have been vaccinated against HPV should still follow all recommended guidelines.
  • Women who have had a hysterectomy without removal of the cervix should continue screenings as recommended.
• Women who have had a total hysterectomy should stop screening—unless it was done to treat cervical pre-cancer.

These guidelines do not apply to women who have been diagnosed with cervical cancer, cervical pre-cancer, or HIV infection. These women should have follow-up testing and cervical cancer screening as recommended by their healthcare providers.

Signs and Symptoms of Cervical Cancer

Women with early cervical cancers and pre-cancers often show no symptoms—that’s why it’s so important to have regular screenings by your healthcare provider.

However, there are several risk factors that increase your chance of developing cervical cancer:

• Being overweight
• Being younger than 17 at your first full-term pregnancy
• Chlamydia infection
• Diet low in fruits and vegetables
• Diethylstilbestrol (DES)
• Family history of cervical cancer
• Having a weakened or suppressed immune system
• Having multiple full-term pregnancies
• HPV infection
• Intrauterine device (IUD) usage
• Low-income status, or lack of access to adequate healthcare services
• Smoking

Most women do not experience symptoms until a pre-cancer becomes a true invasive cancer and spreads to other tissues. If this occurs, you may experience these symptoms:

• Abnormal vaginal bleeding
• Abnormal vaginal discharge
• Pain during intercourse

While these symptoms are not always related to cervical cancer, you should consult your healthcare provider immediately if you are experiencing any of these symptoms. Otherwise, begin regular screenings as recommended above to monitor your cervical health.

Prevention and Treatment Options

One of the number one ways to prevent cervical cancer is with a screening to find pre-cancerous cells before they become invasive. The second is to prevent the pre-cancerous cells before they begin. Here are a few things to do to prevent pre-cancerous cells and cancers:

• Don’t smoke
• Get vaccinated for HPV
  • The American Cancer Society recommends routine HPV vaccination for girls and boys starting at age 11 or 12, and also for females 13 to 26 years old and males 13 to 21 years old. Males ages 22 to 26, men through age 26 who have sex with men, and people with weakened immune systems (including people with HIV infection) may also be vaccinated.
• To lower your risk of exposure to HPV, consider limiting your number of sexual partners and avoiding sex with people who have had many other sexual partners
• Use condoms to protect against HPV

Once worrisome cells have advanced to true invasive cancer, an oncology care provider will determine the best options for treatment depending on the stage of the disease. In addition to the stage of the disease while diagnosed, your provider may also consider other factors like your age, general health, lifestyle, and personal preferences. For example, cervical cancer can affect your ability to have children, so younger women diagnosed with cancer may prefer a treatment option that takes these factors into consideration, should they want kids later in life.

The most common forms of treatment include:

• Chemotherapy
• Radiation therapy
• Surgery
• Targeted therapy

For earlier stages of cervical cancer, surgery or radiation plus chemotherapy may be used. For cases at later stages, radiation plus chemotherapy is the main treatment. Chemotherapy alone is often used to treat advanced cancers. Our expert team of cancer specialists will always help you make the best decisions for your needs.

Get Screened!

We can’t stress enough the importance of regular screening. Cervical cancer rarely presents any symptoms in its early stages, which makes it all the more important to screen for pre-cancerous cells as early as possible. Screening can treat most abnormal cells before they have the chance to turn into cervical cancer, and significantly increase chances of survival.

Don’t skip your annual well woman visit. Schedule an annual appointment with your primary care provider today to discuss your screening options.